2025-03-31-accounts

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

Action against Medical Accidents

Report and financial statements for the year ended 31 March 2025

Action against Medical Accidents

For the year ended 31 March 2025

Reference and administrative details .................................................................................................... 3 Report of the Board of Trustees ............................................................................................................ 5 Independent auditor’s report ................................................................................................................ 19 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 2025

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 principaloffice	82 Tanner Street,
address	London SE1 3GN
Patrons	Peter Ransley	(Honorary Life President)
	James Badenoch KC
Honorary officers	Jocelyn Cornwell	Chair
	Michele Salter	Treasurer
	Caroline Browne	Senior Independent Director
Trustees	Michael Andersson
	Caroline Browne
	Janine Collier
	Jocelyn Cornwell
	Agnelo Fernandes	(appointed March 2025)
	Stephanie Howden	(appointed March 2025)
	Amrat Khorana
	Bill Kilvington
	Harriet Leyland	(Associate Trustee appointed March 2025)
	Carol Parsons
	Farrah Pradhan	(appointed December 2024)
	Michele Salter
Key management personnel	Paul Whiteing	Chief Executive
	Nathan Bacon	Operations Director
	Nicky Rushden	Finance Manager (resigned March 2025)
	Lisa O’Dwyer	Medico Legal Services Director
	Ed Maycock	Head of Events
	Anna Devine	Director of Fundraising, Marketing & Comms
		(from November 2024)
	Tim Hammond	Head of Finance (From June 2025)

Action against Medical Accidents

Reference and administrative details

For the year ended 31 March 2025

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 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

Action against Medical Accidents

Report of the Board

For the year ended 31 March 2025

The Board of Trustees presents its report and the audited financial statements for the year ended 31 March 2025.

Reference and administrative information set out on pages 3 and 4 form 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”.

Our beneficiaries – those we support

We support people affected by avoidable medical harm in healthcare and help them get the outcome they need. They, alongside other people, benefit from the wider public benefit that arises from the changes in policy and practice we aim to bring about through our public education, influencing and campaigning. Below we describe how we help our beneficiaries through our main activities.

2024-25: A Summary

The year marked the start of an exciting chapter for AvMA, as we began work on our fiveyear strategy (2024/29). Our key strategic objectives are:

To expand the range of communities we serve to enable more people experiencing avoidable medical harm to access our support and services.
To empower more people to secure the outcome they need following an incident of avoidable medical harm while providing care and compassionate support.
To eliminate compounded harm following avoidable medical harm.
To have the necessary diversity of sustainable resources and capacities to deliver this strategy.

The Board, which meets four times a year, has monitored the progress and delivery of our first-year objectives within that plan:

After careful due diligence and legal advice as well as securing a report in accordance with the Charities (Disposition of Land: designated Advisers and Reports) Regulations 2023, the Board decided to dispose of the charity’s Croydon office, and the property was sold in August 2024. AvMA now operates on a fully remote working basis and has a shared office space in central London. This is helping to diversify the geographical basis of our staff and making us more representative of the UK-wide population that we serve.
In line with our objective to increase and diversify our income, the charity recruited a Director of Fundraising, Marketing & Communications late in 2024. Expanding our expertise in diversifying and growing income streams will help AvMA support more harmed patients and their families.

Action against Medical Accidents

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More generally continuing work to widen our reach to groups of people and communities who might not otherwise be aware of our services and who otherwise suffer detriment as a result of a medical incident.
We campaigned on a range of areas of healthcare and justice policy, harnessing the testimony of those we support to highlight deficiencies that clearly require improvement and collaborating with the system to make care safer for all.
We increased our reach by 3%, supporting 3,105 individuals following harm. What’s more, we continued to receive excellent feedback from our beneficiary community for the quality of the advice we provide.
We consulted on our ‘Harmed Patient Pathway’ to better support patients and their families after harm occurs and prevent compounded harm that is all too common in these cases. Our extensive consultation on the Pathway’s core commitments garnered nearly 150 responses from both patients and healthcare professionals/bodies.
The Board held an awayday in the year and used part of that day to reflect on, and benchmark themselves against the Chairity Code of Good Governance. The Board concluded that their governance arrangements were effective, but they identified further room for improvement which is being carried forward and will include further opportunities to review their own conduct through one-to-one appraisal with the Chair and a review of the Chair’s performance led by the Senior Independent Director.
At the end of the year, we held our Annual Clinical Negligence Conference in Bournemouth, with a record 68 exhibitors supporting the event as well as a near record number of delegates.

Advice, Information and Support

The advice and support we provide to people affected by avoidable harm in healthcare is at our core and the experiences of those we help and inform us about everything we do. In 2024-25 we directly helped 3,105 people (3,008 in 2023-24) with a great many others benefiting from our self-help guides and the information we provide through our website. However, we know that there are many more people who need our support – in fact, for every call we can answer we know we miss another. We are especially aware that there is more we need to do to help individuals from disadvantaged communities access our services.

AvMA is the only charity providing a specialist medico-legal helpline in the UK and we continue to make every effort to promote our services to other organisations that signpost people for advice and assistance.

Our helpline provides specialist, sympathetic support to people when they are coping with traumatic experiences. Facing the magnitude and complexity of the NHS and justice system, AvMA reassures harmed patients that they are not alone: we understand their plight and want to support them. Our helpline staff and volunteers help people understand their rights, explain how different medico-legal processes and procedures work, including how to complain to the NHS and Health Ombudsman, and can put them in touch with other specialist support where needed. By the end of the year, we had just over 100 trained volunteers working on our helpline. We are grateful to all the volunteers who enable us to make this service available Monday to Friday 10am-3.30pm. In 2024-25 we advised on 2,527 calls (2,451 in 2023-24). These are often extremely serious and complex cases.

Action against Medical Accidents

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For the year ended 31 March 2025

AvMA's Medico Legal Advisors are all experienced professionals with either medical and/or legal qualifications, 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 2024-25 we opened 488 new casework files (480 in 202324).

IMPACT: Callers to our helpline and recipients of our written casework service frequently tell us that they feel understood and supported at a time of extreme stress and anxiety. They are empowered to make better informed decisions about what to do next through our specialist advice and better equipped to make use of the procedures available to them. Often, this results in

access to a specialist solicitor and eventual redress
complaints or concerns properly addressed and resolved by healthcare systems.
achieving measures to protect other patients/improve patient safety.

Our Inquest Service

AvMA understands the importance of seeking answers after harm, to make sense of what has happened and to aid acceptance. This process is especially important when seeking answers after the death of a loved one, and we feel privileged to support families involved in healthcare-related inquests, courtesy of barristers giving their time, advocacy skills and expertise freely.

Our support empowers families and maximises opportunities for patient safety issues to be identified, through either written questions or representation by counsel at the inquest hearing. Families are consistently motivated by a desire to establish the truth and to honour the memory of their loved ones by preventing harm to others. Whereas NHS bodies and individual health professionals are usually legally represented at inquests, bereaved families are usually not and there is limited legal aid funding for such representation. 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.

We gave advice and information to 81 families who were facing a forthcoming inquest last year, helping them to prepare and/or to get legal representation at the inquest. These cases can be highly complex and time-consuming. As demand for the inquest service far exceeds what we can supply, we use written criteria to judge all applications for representation.

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 of Future Death reports. In some circumstances, Serious Investigation Reports (SIR) or equivalent investigation processes were instigated as a direct result of AvMA’s involvement. Sometimes NHS trusts will produce an Action Plan as part of the SIR. These may be just as influential because the impetus for change comes from the trust itself, not by direction of the coroner. However, there is no independent organisation to confirm that the action promised has been introduced. We therefore support the creation of a National Oversight Mechanism to ensure that actions and recommendations are implemented.

IMPACT: We ensure that people who have lost a family member as a result of avoidable harm are given information and advice on the coronial process, and on the

Action against Medical Accidents

Report of the Board

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terms of the pro bono inquest service. The families we are able to assist feel empowered by having a legal representative raise relevant points of law and pose questions to the coroner and other witnesses attending to give evidence at inquests.

Policy and external relations (Influencing Policy & Practice)

We know that individuals reaching out for AvMA’s support are often facing some of the most challenging times in their life. Time and again what we hear from those we have helped is that they want to prevent others from having to go through the same experiences. That’s where our policy and campaign work comes in, ensuring the voices and opinions of harmed patients are heard by those in power who can make improvements within the system.

In 2024-25, AvMA policy and campaign work focused on healthcare and access to justice inequalities, highlighting systemic issues that hinder patient safety and transparency. Collaborating with the Harmed Patient Alliance we developed and consulted on a Harmed Patient Pathway which uses principles of restorative justice to better meet the needs and support healing for patients and their families after harm has occurred.

AvMA also became member of the secretariat for the newly formed All-Party Parliamentary Group (APPG) on Patient Safety in 2024. The APPG, chaired by Sir Jeremy Hunt MP, brings AvMA’s expertise and understanding of the patient perspective to parliamentarians at a time when conversations in Westminster about the future patient safety and health policy are as necessary as they have ever been.

In 2024-25, we drafted seven consultation responses and evidence submissions to government and regulatory bodies about healthcare and legal reforms putting the patient perspective:

to the Professional Standards Authority’s consultation on their good practice guidance documents in support of regulatory reform, April 2024
to the consultation on proposed changes to the Putting Things Right (PTR) process, April 2024
to the Department of Health and Social Care Duty of Candour review, May 2024
to the Ministry of Justice consultation on reforming the Law of Apologies in England and Wales, June 2024
to the Department of Health and Social Care consultation on NHS 10-Year Health Plan, November 2024
to the Department of Health and Social Care consultation on proposals to regulate NHS managers, February 2025
to the Civil Justice Council’s consultation on Review of Litigation Funding, March 2025

AvMA was featured in 16 media enquiries and interviews, covering national newspapers, TV, radio and local media and we remain active on social media. As well as responding to unfolding patient safety stories, we look for opportunities to amplify our campaign priorities, raise our profile and promote our work to those who may be in need of our services.

Crucial to our work to raise awareness of harmed patients’ perspectives is our ability to influence and engage across the healthcare, legal and professional regulatory space.

Action against Medical Accidents

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During the year we engaged with over 30 organisations as well as meeting frequently with other campaigners, charities and groups with an interest in patient safety and access to justice to identify opportunities for collaboration, joint campaigning and information sharing. We now belong to National Voices, a coalition of over 200 healthcare charities in England.

IMPACT: Our work on a Harmed Patients Pathway should mean that more people will get the right support they need in a compassionate and timely way. Our work to raise awareness of restorative approaches is already garnering interest in the healthcare professions, and acknowledgement that the way patients are currently treated in the aftermath of harm is not sufficient. Our work in speaking truth to power should help ensure that the patient safety landscape better meets the needs of patients after harm has occurred.

Conferences and training (Spreading awareness and good practice) AvMA helps patients and their families to navigate their experiences of medical harm, seeking answers, support and, where appropriate, redress. Our events programme supports professionals through the development and nurturing of skills, knowledge and relationships. Bolstering the resources available to patient safety and justice communities better enhances outcomes for harmed patients.

A total of 1,254 delegates attended AvMA’s seven in-person conferences and events in 2024-25. We also ran nine live webinars, which were watched by 372 people at the time of broadcast, with a further 776 viewings of the recordings.

Our flagship conference, the Annual Clinical Negligence Conference (ACNC), took place in March 2025 in Bournemouth and attracted 470 attendees, and a record 68 exhibitors. There remains a continuing appetite among delegates and sponsors for larger scale events of this nature which combine professional development with networking opportunities.

IMPACT: Enhancing the skills and knowledge of legal and health professionals’ results in our beneficiaries receiving good quality, up to date advice and representation from them.

AvMA’s specialist accredited Clinical Negligence Solicitors Panel

Although most people AvMA helps do not take legal action, some need the services of solicitors. We continue to assess and accredit clinical negligence solicitors for our specialist clinical negligence panel to help our beneficiaries receive care and expertise when seeking justice. AvMA’s quality mark is the best indicator available that a solicitor has 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. Interest in joining AvMA’s panel remains strong: we now have 169 panel members (with 33 re-accreditations of panel membership within the year)

A key aim of the AvMA Panel is to improve 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, and always focused 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

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thereby ensuring that their clients receive the best service in these circumstances. We are very grateful to the 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, makes it easier for those we support 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, swift and cost-effective outcome.

Medico-legal services

In addition to awarding our AvMA panel accreditation quality mark, AvMA runs a Lawyers’ Service. Legal firms subscribing to the Lawyers’ Service can access a database of over 600 medico-legal experts. Experts are only accepted if they can meet the high standards set out in the Expert Protocol. AvMA will provide Lawyer Service member firms with details of relevant medico-legal experts to help them investigate the client/beneficiaries case as independently, impartially and honestly as possible, assisting law firms to 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.

In addition, AvMA has continued to work in collaboration with NHS Resolution, and the Society of Clinical Injury Lawyers (SCIL) to produce a successor to the Covid 19 Protocol, the Clinical Negligence Claims Agreement (CNCA) which came into effect on 28[th] August 2024. The key benefits for harmed patients in the new agreement include: extended limitation periods for certain cases, providing flexibility for claimants and their representatives; an emphasis on early disclosure of relevant documentation to help narrow issues and reduce investigation costs; encouragement of pre-action discussions and dispute resolution to avoid unnecessary litigation. Most significantly, the agreement includes a term that in cases where liability is admitted, a meaningful letter of apology should be provided as soon as possible.

IMPACT: Litigation on its own cannot produce an outcome on learning and change, but initiatives such as the Clinical Negligence Claims Agreement help to promote the smooth running of cases, early resolution where possible and assurance to the patients/clients that lessons have been learned.

Our support services for solicitors practicing clinical negligence also mean that our beneficiaries are more likely to experience a good service and a successful result. By accessing an appropriate medico-legal report law firms can better identify the case’s prospect of success at the earliest opportunity. Those cases that do not have reasonable prospects of succeeding are turned down quickly. This reduces the stress on clients and those which continue should have substantive issues and a good chance of being resolved.

AvMA’s work in Scotland and the other Nations of the UK

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 continue to look for opportunities to work and support people from across all four nations of the UK and are currently assessing how we might further support people across Scotland, Wales and Northern Ireland given our stretched resources.

Action against Medical Accidents

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For the year ended 31 March 2025

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.

Fundraising

AvMA is a member of the Fundraising Regulator Scheme and follows its code of conduct. The charity has a fundraising policy on donations (including legacies), corporate funding, sponsorship and support. We are committed to adhering to the Fundraising Promise and Code of Fundraising Practice issued by the Fundraising Regulator. As such, we strive to live up to the same level of transparency and integrity which we expect of other public bodies and professions, including the protection of vulnerable people who wish to support the charity. During the year, AvMA’s main fundraising activities came from donations from supporters and corporates, fundraising events held by other organisations, corporate sponsorship, and occasional bequests. The charity did not receive any fundraising complaints or requests from the Fundraising Regulator and did not engage with third parties or commercial participators.

Recognising the need to build a more sustainable and diverse income base, we acted on professional advice and appointed a Director of Fundraising, Marketing and Communications in early 2025. Since then, significant time and effort has been invested in building the foundations needed for long-term fundraising success. This includes developing structured supporter journeys, establishing new digital donation processes, strengthening our brand offer to corporates, and creating the operational systems required to manage increased fundraising activity. To support any increased fundraising activities, we will continue to review our Fundraising policies and any use of third parties, to ensure that the charity adheres to the Charity Commission Code of Fundraising Practice, training staff and volunteers appropriately.

We are under no illusion that this is a quick win. Developing robust processes, clear cases for support, and the trust of grant-making bodies takes time. While early progress is encouraging, including new campaigns, tools, and outreach, the income returns will grow over time as we build deeper engagement with our supporters, service users, and external partners.

Looking ahead, AvMA’s refreshed fundraising strategy prioritises areas where we can grow and sustain our reach. These include digital giving, trusts and foundations, and missionaligned corporate partnerships. A new fundraising volunteer model, modernised website, and clearer storytelling around impact will help strengthen our offer to potential funders. This work sits alongside the broader pressures identified elsewhere in this report, including rising service demand and capacity constraints. Fundraising is positioned as a critical longterm enabler of AvMA’s mission.

Assuring the quality of our work

The charity has a Service Delivery, Quality and Outcomes Committee to help take forward its work on quality and impact measurement. Part of the Committee’s remit is to review any complaints made about AvMA’s work and be sure that any learning points are acted upon. We received one formal complaint about AvMA during the year which we investigated

Action against Medical Accidents

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thoroughly. We continue to monitor feedback and investigate any concerns expressed by users of our services.

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 objectives from 2024-2029 and our plans for achieving them.

All of our work plans are driven by the four key strategic objectives set out above.

Within the context of those objectives key priorities for 2025/26 include:

Development of a new website that can improve our reach for existing and other people in need of our services. As part of this work, we expect to re-fresh the AvMA brand.
Commission a review of our services to ensure that they remain effective and are helping to reach those who do not use our services. This will include helping us to overcome the challenges we face with the helpline where demand outstrips our ability to answer the calls – for every we call we take we currently lose one due to lack of capacity.
Completion of the implementation of a new CRM (database) – the biggest infrastructure investment AvMA has ever made, which will greatly improve our efficiency. We expect to complete the final phases of implementation in the year ahead.
Further development of the ‘Harmed Patient Pathway, seeking to ensure a consistent approach is taken to meeting the needs of harmed patients and their families.
Continuing policy and influencing work around possible further Government clinical negligence reforms, the pre-cursor to which is the review being led by David Lock KC, announced as part of the Governments NHS 10 Year Plan.
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.
Continuing to consider ways in which we can meaningfully support our beneficiaries who are unable to secure legal representation.
Continuing 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.

“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 function. We are very grateful to all our supporters; donors; paying customers; and business partners for making this happen.

Action against Medical Accidents

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We would like to say a special thank you to the following people and organisations who supported us in 2024-25:

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)
Pentland Medical (our Silver ‘Partners for Patient Safety’ corporate member)
The many sponsors and exhibitors of all our conferences and events
The core group of people who have worked with us to co-produce the Harmed Patient Pathway.

We would also like to thank all of our volunteers, not least 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. These governing documents are regularly reviewed by the Board of Trustees to ensure that the charity is not undertaking activities that fall outside its charitable purposes (objects), and its governance follows good practice.

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 six nor more than 15 Board members may be appointed. The Board may co-opt people to fill casual vacancies provided the maximum of 20 is not exceeded. Trustees who are appointed to the Board for a period of three years. Retiring members are eligible for reelection at the Annual General Meeting on two subsequent occasions and may not serve longer than nine years in total.

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. It is our practice to advertise publicly explaining the criteria and skills being sought. Potential new trustees are interviewed by at least two trustees, usually including the Chair. 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 trustee role. They are not legally full trustees and so are not registered with Companies House or the Charity Commission.

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During the year three new trustees and one associate trustee were appointed. This brings the total number of trustees to eleven at the year end, plus one associate trustee.

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. Declarations of Interest are discussed and put on each Board and Committee agenda. Any conflicts of interest are added to a Conflict-of-Interest Register.

The Board meets a minimum of four times a year.

Members of the charitable company guarantee to contribute an amount not exceeding £1 to the assets of the charitable company in the event of winding up or within one year after they cease to be a member. The total number of such guarantees on 31 March 2025 was 11

(not including the associate trustee). Members of the Board of Trustees have no beneficial interest in the charitable company.

The Board is supported by four Committees – Resource Committee, Service Delivery, Quality & Outcomes Committee, Income Generation, Events and Marketing Committee and the Information, IT, Risk & Compliance. Each Committee meets four times a year between Board meetings and undertakes more detailed scrutiny of areas of the charity’s remit, which in the view of the Board, require additional oversight and scrutiny.

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 2024-25.

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. Caroline Browne - Senior Independent Director was reappointed in December 2023 alongside Michele Salter who was appointed 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 under the policies of a delegation framework and delegation authority limits.

Patrons

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

Remuneration of key management personnel

The Board of Trustees has a remuneration policy covering all employees. Salary levels are set and reviewed through trustees’ review of salaries available in comparable organisations and by reference to the NJC and NHS Pay Scales. Annual cost of living increments is

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awarded at the discretion of the Board of Trustees, with reference to the Consumer Price Index for the previous calendar year and bearing in mind the charity’s finances and the financial climate generally. AvMA’s full remuneration policy is published on the charity’s website.

Financial Review

Despite continuing challenging economic conditions, the Trustees were grateful for the continued generosity of AvMA supporters which resulted in the charity receiving in total income £1,448k (2024: £1,493k). In comparison to the previous year, income from charitable activities decreased, mitigated by a slight increase in voluntary income. Despite the overall decline in income the charity used some reserves to spend 14% more funds on its charitable activities during the year. Enabling more people who suffer avoidable medical harm to get the support and the outcomes they need.

Demand for our vital services continues to grow and AvMA is completely reliant on its own

income generation activities with no State support. The trustees approved the recruitment of an experienced Fundraising lead to develop a fundraising strategy to increase the growth and diversification of its income generating activities. This resulted in a slight increase in the costs of raising funds, 2025: £78k (2024: £57k). Although voluntary income rose slightly during the year, the fundraising strategy will take time to establish and will require increased AvMA supporters and sponsors. During the year, including legacy income, for every £1 invested in fundraising, £2.68 helped fund charitable activities. At year end AvMA’s balance sheet remained healthy; debtors decreased by £149k and cash increased following the sale of property, partly previously used as an office for the charity. Trustees approved the sale to support the charity in reducing operating costs and freeing up cash for the charity to invest in key strategy objectives to review and increase its charitable services.

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. Various legal changes have already created difficulties for law firms wishing to practice clinical negligence, which is seeing mergers or firms dropping out of clinical negligence work. This is, in turn, increasing pressure on our abilities to generate income. Charity is addressing this risk by attempting to diversify and develop new sources of income through fundraising activities. The situation is kept under constant review.

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 long- term 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.

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Reserves and Investment Policy

Background and financial strategy

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

The trustees have a five-year financial strategy which runs concurrently with the overall strategy to address the situation on a timely and considered basis. Our financial strategy is to move to a sustainable balanced budget over the five years of the strategic plan, against the background of anticipated contraction of our traditional revenue streams, through developing new sources of fundraising income and making cost efficiencies in a carefully controlled manner. This is reviewed each year on a rolling basis.

We plan to utilise our current designated reserves to help fund an approved 5-year strategy, supported by a transitional fund, to ensure we have set aside reserves to manage our day-to-day charitable activities whilst we provide necessary investment to

successfully meet our strategic goals, against an environment of continuing economic uncertainty.

The designated funds will support investment in our strategic aims to reach more communities with our services. Increase awareness of our vital charitable activities, working collaboratively with government and health care providers to change policy and improve practice via our patient safety and campaigning work. Continually improve efficiency in our IT infrastructure and provide improved longer-term financial sustainability through increasing and diversifying income generating growth, mainly through investing in new fundraising initiatives. Also to continue to invest carefully in new development activities as appropriate.

Most of these designated funds are expected to be spent and the balance to be near target level by the end of the strategy period.

Reserves policy

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 £1,195k

Level of reserves

Note 20a, movements in funds, shows we have general reserves of £1,061k at the year-end. This general fund amount was just below our reserves policy explained above, resulting in £100k of designated reserves (transitional fund) required to fund this deficit .

Action against Medical Accidents

Report of the Board

For the year ended 31 March 2025

Designated reserves reduced from 2024: £2,822k to 2025: £2,687k with funds spent on IT infrastructure, preparing for the sale of property in August 2024 and supporting the start of a fundraising strategy.

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 longterm investment portfolio managed by Castlefield and Tavistock. 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%. Although the Castlefield investment did not perform to target return during the year, due to difficult economic global markets. The trustees were pleased these investments had returned 10.95% since inception. The net value of both investment portfolios rose by £22k by year end.

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.
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.

Action against Medical Accidents

Report of the Board

For the year ended 31 March 2025

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 9 December 2025 and signed on its behalf by

Paul Whiteing Company Secretary

Independent auditor’s report

To the members of Action Against Medical Accidents

For the year ended 31 March 2025

Opinion

We have audited the financial statements of Action against Medical Accidents (the ‘charitable company’) for the year ended 31 March 2025 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 2025 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.

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

Independent auditor’s report

To the members of Action Against Medical Accidents

For the year ended 31 March 2025

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
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.

Independent auditor’s report

To the members of Action Against Medical Accidents

For the year ended 31 March 2025

Auditor’s responsibilities for the audit of the financial statements

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

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

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

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 non-compliance with laws and regulations.
We inspected the minutes of meetings of those charged with governance.
We obtained an understanding of the legal and regulatory framework 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.

Independent auditor’s report

To the members of Action Against Medical Accidents

For the year ended 31 March 2025

Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation.

A further description of our responsibilities is available on the Financial Reporting Council’s website at: www.frc.org.uk/auditorsresponsibilities . This description forms part of our auditor’s report.

Use of our report

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

Noelia Serrano (Senior statutory auditor) Date: 11 December 2025 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

Action Against Medical Accidents

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

For the year ended 31 March 2025

Note Income from: 2 3 3 3 4 5 6 6 6 6 6 Charitable trading activities 6 14 13b 13a 7 Reconciliation of funds: 20 20 Advice, information and support Conferences and training Medico-legal services Donations and legacies Charitable activities Net (expenditure) / income before net gains on investments Other trading activities Total expenditure Charitable activities Advice, information and support Policy and external relations Conferences and training Medico-legal services Investments Other Total income Raising funds Expenditure on: Total funds carried forward Total funds brought forward Net gains on investments Net (expenditure) / income for the year Net (losses) on investment property (Impairment loss) on leasehold property	Unrestricted £ 287,887 473,173 421,015 14,452 168,351 82,869 359	2025 Total £ 287,887 473,173 421,015 14,452 168,351 82,869 359 1,448,106 78,217 533,361 394,342 460,120 83,896 35,863 1,585,799 (137,693) 22,662 - - (115,031) 3,863,011 3,747,980	2024 Unrestricted Total £ £ 278,241 278,241 521,664 521,664 407,641 407,641 9,981 9,981 168,531 168,531 105,722 105,722 1,185 1,185 1,492,965 1,492,965 57,386 57,386 462,766 462,766 356,977 356,977 389,557 389,557 73,477 73,477 38,615 38,615 1,378,778 1,378,778 114,187 114,187 15,672 15,672 (93,769) (93,769) (26,231) (26,231) 9,859 9,859 3,853,152 3,853,152 3,863,011 3,863,011
	1,448,106
	78,217 533,361 394,342 460,120 83,896 35,863
	1,585,799
	(137,693) 22,662 - -
	(115,031) 3,863,011
	3,747,980

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.

Action Against Medical Accidents

Balance Sheet

For theyear ended 31 March 2025 Note Fixed assets: Intangible assets 12 12 13a 13b 14 Current assets: 15 Liabilities: 16 20 Total unrestricted funds Debtors Unrestricted income funds: Designated funds Creditors: amounts falling due within one year General funds Total charity funds The funds of the charity: Net current assets Total net assets Investments Cash at bank and in hand Tangible assets: other Tangible assets: leasehold property Investment property	For theyear ended 31 March 2025		CompanyNo 02239250 2025 2024 £ £ £ 223,948 189,884 11,617 5,911 - 327,884 - 1,172,116 2,624,651 1,147,996 2,860,216 2,843,791 317,687 887,475 1,205,162 185,942 887,764 1,019,220 3,747,980 3,863,011 2,822,098 1,040,913 3,747,980 3,863,011 3,747,980 3,863,011
		£ 168,896 1,039,373
		1,208,269 320,505
		2,686,573 1,061,407

Approved by the trustees on 9th December 2025 and signed on their behalf by

Dr Jocelyn Cornwell Chair

Michele Salter Treasurer

Action Against Medical Accidents

Statement of cash flows

For the year ended 31 March 2025

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

Net (expenditure) / income for the reporting period (as per the statement of financial activities) Depreciation and amortisation charges (Gains) on investments Loss on property revaluation Dividends, interest and rent from investments Decrease / (increase) in debtors Increase / (decrease) in creditors Net cash provided by / (used in) operating activities Analysis of cash and cash equivalents and of net debt Cash at bank and in hand Notice deposits (less than three months) Total cash and cash equivalents Total Cash and cash equivalents at the end of the year Change in cash and cash equivalents in the year Cash flows from operating activities Net cash from investing activities Cash flows from investing activities: Dividends, interest and rents from investments Purchase of fixed assets Proceeds from sale of Fixed Assets Purchase of fixed asset investments and cash invested into portfolio Net cash provided by / (used in) operating activities Cash and cash equivalents at the beginning of the year	£ 82,869 (74,283) 1,500,000 (1,453,993)	£ 97,305 54,593 151,898 887,475 2025	2025 2024 £ £ (115,031) 9,859 34,513 24,359 (22,662) (15,672) - 120,000 (82,869) (105,722) 148,791 (194,847) 134,563 (121,229) 97,305 (283,252) £ £ (283,252) 105,722 (44,297) 123,679 (134,479) 50,625 (232,627) 1,120,102 887,475 Cash flows At 31 March 2025 £ £ 59,370 316,435 92,528 722,938 151,898 1,039,373 151,898 1,039,373 2024

		1,039,373
		At 1 April 2024 £ 257,065 630,410
		887,475
		887,475

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

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 Canopi, 82 Tanner Street, London, SE1 3GN.

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.

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

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.

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

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
Office equipment and furniture  Databases

3 years 5 years 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. At the end of the year the charuty had no property investments following a property sale in August 2024

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.

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

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

Experts' donations Other fundraising Other donations Corporate donations Unclaimed clients' money Legacies	2025 2024 Total Total £ £ 5,650 7,806 51,606 24,428 191 715 203,740 232,000 15,363 7,725 11,337 5,567 287,887 278,241

All funds for 2025 and 2024 were unrestricted.

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

3 Income from charitable activities

Sponsored leaflets
4
Corporate sponsorship
5
Rent
Delegate, sponsor and webinar income
Total income from charitable activities
Dividends and interest
Income from investments
Total: conferences and training
Subscription fees
Website subscriptions
Publications
Total: medico-legal services
Other
Lawyers' service directory
All funds for 2025 and 2024 were unrestricted.
All funds for 2025 and 2024 were unrestricted.
AvMA events
Fees earned
Referral panel fees
Income from other trading activities
Total: advice, information and support

2025
2024
Total
Total
£
£
473,173
521,664
473,173
521,664
397,647
392,553
23,368
15,088
421,015
407,641
14,452
9,981
-
-
14,452
9,981
908,640
939,286
2025
2024
Total
Total
£
£
1,118
5,569
139,032
131,958
5,927
5,927
21,357
13,006
-
1,169
917
10,902
168,351
168,531
2025
2024
Total
Total
£
£
70,702
56,781
12,167
48,941
82,869
105,722

All funds for 2025 and 2024 were unrestricted.

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

6a Analysis of expenditure (current year)

Cost of raising funds £ 44,860 435 264 - - - 444 - - - - -	Conferences and training £ 147,803 230,698 - - - - 233 - - - - -	Medico-legal services Advice, information and support Policy and external relations £ £ £ 198,175 233,448 49,156 10 359 - - 21 526 - 7,540 - - - - - - - 2,874 421 2,000 - 5,721 - - - - - - - - - - - - - 201,059 247,510 51,682 177,288 195,016 29,548 15,995 17,594 2,666 394,342 460,120 83,896 356,977 389,557 73,477 Charitable activities	Medico-legal services Advice, information and support Policy and external relations £ £ £ 198,175 233,448 49,156 10 359 - - 21 526 - 7,540 - - - - - - - 2,874 421 2,000 - 5,721 - - - - - - - - - - - - - 201,059 247,510 51,682 177,288 195,016 29,548 15,995 17,594 2,666 394,342 460,120 83,896 356,977 389,557 73,477 Charitable activities	Medico-legal services Advice, information and support Policy and external relations £ £ £ 198,175 233,448 49,156 10 359 - - 21 526 - 7,540 - - - - - - - 2,874 421 2,000 - 5,721 - - - - - - - - - - - - - 201,059 247,510 51,682 177,288 195,016 29,548 15,995 17,594 2,666 394,342 460,120 83,896 356,977 389,557 73,477 Charitable activities	Charitable trading activities £ 16,285 - - - - - - - - 250 - -	Governance costs £ 38,939 - 1,194 - - 11,451 1,695 - - - - 36	Support costs £ 280,574 - 2,512 - 12,972 69,451 91,653 88,549 34,513 5,779 - 4,958
46,003 29,548 2,666	378,734 141,831 12,796	201,059 177,288 15,995	247,510 195,016 17,594	51,682 29,548 2,666	16,535 17,729 1,599	53,315 - (53,315)	590,961 (590,961) -
78,217	533,361	394,342	460,120	83,896	35,863	-	-
57,386	462,766	356,977	389,557	73,477	38,615	-	-

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

6b Analysis of expenditure (prior year)

Cost of raising funds £ 30,886 - - - - - 290 - - - - -		Charitable activities	Charitable activities	Charitable activities		Governance costs £ 31,771 - 916 - - 11,937 1,754 - - - - 26
	Conferences and training £ 140,913 196,041 5 - - - - - - - - -	Medico-legal services £ 196,751 270 108 - - - 2,589 - - - - -	Advice, information and support £ 205,098 - 200 6,447 - - 349 4,479 - - - -	Policy and external relations £ 46,864 - 403 - - - - - - - - -	Charitable trading activities £ 21,943 578 - - - - 368 - - - - -
31,176 23,890 2,320	336,959 114,670 11,137	199,718 143,338 13,921	216,573 157,671 15,313	47,267 23,890 2,320	22,889 14,334 1,392	46,404 - (46,404)
57,386	462,766	356,977	389,557	73,477	38,615	-

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

7 Net outgoing resources for the year

This is stated after charging / (crediting):

This is stated after charging / (crediting):
	2025	2024
	£	£
Depreciation	34,513	24,359
Auditor's remuneration (excluding VAT):
Audit - current year	9,785	9,500
Foreign exchange (gains)	-	(33)

8 Analysis of staff costs, trustee remuneration and expenses, and the cost of key management personnel

Staff costs were as follows:

Social security costs Employer’s contribution to defined contribution pension schemes Salaries and wages	2025 2024 £ £ 897,690 814,201 91,695 74,806 19,855 18,644 1,009,240 907,651

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

		2025	2024
		No.	No.
£80,000	- £89,999	2	2
£70,000	- £79,999	-	-
£60,000	- £69,999	-	-

The total employee benefits including pension contributions and employer's national insurance of the key management personnel were £391,503 (2024: £202,155).

The charity trustees were not paid or received any other benefits from employment with the charity in the year (2024: £nil). No charity trustee received payment for professional or other services supplied to the charity (2024: £nil).

Trustees' expenses represents the payment or reimbursement of travel, subsistence and accommodation costs totalling £372 (2024: £807) incurred by 3 (2024: 7) members relating to attendance at trustee meetings and events.

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

9 Staff numbers

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

Conferences and training Advice, information and support Support Governance Policy and external relations Charitable trading activities Raising funds Medico-legal services	2025 2024 No. No. 0.7 0.6 3.7 3.7 4.7 4.5 5.4 4.8 0.7 0.7 0.3 0.4 5.8 5.6 0.6 0.5 21.9 20.8

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

Conferences and training Medico-legal services Raising funds Charitable trading activities Advice, information and support Policy and external relations Support Governance	2025 2024 No. No. 0.7 0.6 3.0 3.0 3.7 3.6 4.8 4.1 0.7 0.6 0.3 0.4 5.1 4.8 0.5 0.5 18.8 17.6

10 Related party transactions

There are no related party transactions to disclose for 2025 (2024: none).

There are no donations from related parties which are outside the normal course of business and no restricted donations from related parties (2024: none).

11 Taxation

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

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

12 Tangible and intangible fixed assets

Tangible and intangible fixed assets
Written off in year At the start of the year Additions in year At the start of the year Eliminated on disposal At the end of the year At the start of the year Depreciation Net book value At the end of the year Cost or valuation At the end of the year Charge for the year	Computer equipment and website (Tangible) £ 46,612 12,991 (665)	Office equipment and furniture (Tangible) £ 6,368 - (4,622)	MS Dynamics CRM database (Intangible) £ 210,982 61,292 -	Total £ 263,962 74,283 (5,287)
	58,938	1,746	272,274	332,958
	40,701 7,285 (665)	6,368 - (4,622)	21,098 27,228 -	68,167 34,513 (5,287)
	47,321	1,746	48,326	97,393
	11,617	-	223,948	235,565
	5,911	-	189,884	195,795

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 final development at the year end; the majority of the work was completed with some modules carried forward to the following year.

13 Property

At the year end the charity no longer owned the leasehold to Freedman House which comprises 4 floors. In August 2024 the charity sold the leasehold for £1,500,000. The original total cost in 2013 was £1,206,659. The recieved sales value agreed to the 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.

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

13a Tangible fixed assets: Leasehold property (Ground floor only)

13b
Transfer to investment property
Transfer to investment property
Transfer from investment property (first floor)
At the start of the year
At the end of the year
Fair value at the start of the year
Fair value at the end of the year
At the end of the year
At the end of the year
Revaluation during the year
(First, second and third floors)
Valuation
Investment property
At the start of the year
Net book value
Depreciation
Sale of Investment Property
Impairment loss
Disposal of Leasehold property
Disposal of Leasehold property

2025
2024
£
£
448,108
512,500
-
(64,392)
(448,108)
-
-
448,108
120,224
107,500
-
26,231
-
(13,507)
(120,224)
-
-
120,224
-
327,884
2025
2024
£
£
1,172,116
1,215,000
-
(93,769)
-
50,885
(1,172,116)
-
1,172,116

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

14 Investments

Net gain on change in fair value Fair value at the start of the year Additions at cost Movements in cash element of portfolio Cash Disposal proceeds Investments comprise: Fair value at the end of the year Share in subsidiary undertaking (see below) Investment Trusts/OEICs/REITs/SICAVs Historic cost at the end of the year	2025 2024 £ £ 1,147,897 1,121,425 1,472,467 123,509 (1,151) (123,679) 22,662 15,672 (17,323) 10,970 2,624,552 1,147,897 - 1,163,911 2,614,478 1,120,511 10,074 27,386 2,624,552 1,147,897 99 99 2,624,651 1,147,996

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 (2024: £99).

15 Debtors

Trade debtors Other debtors Prepayments Accrued income	2025 2024 £ £ 74,219 59,820 5,007 34,413 33,297 27,052 56,373 196,402 168,896 317,687

16 Creditors: amounts falling due within one year

Taxation and social security Accruals Deferred income (note 17) Other creditors	2025 2024 £ £ 50,187 23,609 8,607 10,033 73,250 44,610 188,461 107,690 320,505 185,942

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

17 Deferred income

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

Balance at the beginning of the year Amount released to income in the year Amount deferred in the year Balance at the end of the year	2025 2024 £ £ 107,690 173,969 (107,690) (173,969) 188,461 107,690 188,461 107,690

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 2025 (2024: £nil).

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

Net assets at 31 March 2025 Tangible fixed assets - other Intangible fixed assets - database Fixed asset investments Net current assets	General unrestricted £ - - 173,643 887,764 1,061,407	Designated Total funds £ £ 223,948 223,948 11,617 11,617 2,451,008 2,624,651 887,764 2,686,573 3,747,980

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

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

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

20a Movements in funds (current year)

At 1 April 2024 £ 1,500,000 189,884 5,911 200,000 42,198 23,705 500,000 10,000 120,000 4,900 10,000 15,500 200,000 -	Income & gains £ - - - - - - - - - - - - - -	Expenditure & losses £ - - - (23,000) (61,292) (12,991) (100,000) - - - (1,095) (12,407) (13,604) -
2,822,098	-	(224,389)
1,040,913	1,470,768	(1,361,410)
3,863,011	1,470,768	(1,585,799)
3,863,011	1,470,768	(1,585,799)

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

20b Movements in funds (prior year)

At 1 April 2023 £ 1,620,000 175,551 306 200,000 75,000 10,328 25,000 600,000 110,000 120,000 10,000 10,000 30,000 -	Income & gains £ - - - - - - - - - - - - - -	Expenditure & losses £ - - - - (35,431) - (8,866) - - (5,098) - - (17,759) -	Transfers £ (120,000) 14,333 5,605 - 2,629 (10,328) 7,571 (100,000) (100,000) 5,098 (5,100) - 3,259 200,000	At 31 March 2024 £ 1,500,000 189,884 5,911 200,000 42,198 - 23,705 500,000 10,000 120,000 4,900 10,000 15,500 200,000
2,986,185	-	(67,154)	(96,933)	2,822,098
866,966	1,492,965	(1,415,952)	96,933	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

Action Against Medical Accidents

Notes to the financial statements

For the year ended 31 March 2025

20 Purposes of designated funds

Fixed asset - property: the charity purchased the leasehold to Freedman House on 2 May 2013 for £1.2 million. Excluding selling costs, the property was sold for £1.5 million on 30 August 2024 . Trustees have agreed to designate these proceeds to broadening of our service outreach, as well a resourcing our patient safety policy and campaign work.

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 net of; the cost of assets purchased, less disposals and depreciation during the year.

Major repairs and maintenance: for major works to maintain the value of the property in the future. With the property being sold by year end, the balance of this fund has been transferred to broadening of our service outreach, as well a resourcing our patient safety policy and campaign work.

Transitional fund : to ensure we have set aside reserves to manage our day-to-day charitable activities whilst we provide necessary investment to successfully meet our strategic goals, against an environment of continuing economic uncertainty.

CRM replacement: to complete the CRM database project to replace our legacy system Seneca. Includes development costs and project management. Further funds have been approved to complete the development of the project.

Business development projects: to invest in projects to improve efficiency of the charity

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 the Harmed Patient Pathway.

Property update and file clearing: to smarten up Freedman House and clear/digitise stored documents. This work was completed prior to the sale of the property. The small remaining balance being transferred to strategic investments.

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

Proceeds of Property sale : to broaden of our service outreach, as well a resourcing our patient safety policy and campaign work.These funds are required to review and expand our services, increase awareness of our vital charitable actvities via a patient safety and campaigning work.

21 Capital commitments

At the balance sheet date, the charity had no capital commitments

22 Contingent assets and liabilities

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

23. Post balance sheet events

At the balance sheet date the charity had no significant post balance sheet events

Action against Medical Accidents

Contents

For the year ended 31 March 2025

Reference and administrative details

For the year ended 31 March 2025

For the year ended 31 March 2025

Objectives and Activities

Our beneficiaries – those we support

2024-25: A Summary

Advice, Information and Support

Our Inquest Service

terms of the pro bono inquest service. The families we are able to assist feel empowered by having a legal representative raise relevant points of law and pose questions to the coroner and other witnesses attending to give evidence at inquests.

Policy and external relations (Influencing Policy & Practice)

AvMA’s specialist accredited Clinical Negligence Solicitors Panel

Medico-legal services

AvMA’s work in Scotland and the other Nations of the UK

Public Benefit

Fundraising

Assuring the quality of our work

Plans for the future

“THANK YOU”

STRUCTURE, GOVERNANCE & MANAGEMENT

Board of Trustees and appointment of Board members

Honorary Officers

Delegation of day-to-day running of the charity

Patrons

Remuneration of key management personnel

Financial Review

Principal risks and uncertainties

Reserves and Investment Policy

Reserves policy

Level of reserves

Investment policy

Statement of Responsibilities of the Board of Trustees

Auditor

Paul Whiteing Company Secretary

Opinion

Basis for opinion

Conclusions relating to going concern

Other Information

Opinions on other matters prescribed by the Companies Act 2006

Matters on which we are required to report by exception

Responsibilities of trustees

Auditor’s responsibilities for the audit of the financial statements

Capability of the audit in detecting irregularities

Use of our report

For the year ended 31 March 2025

Balance Sheet

Statement of cash flows

b) Basis of preparation

Notes to the financial statements

1 Accounting policies (continued)

k) Operating leases

l) Fixed assets

m) Listed investments

Investment properties

n) Debtors

o) Cash at bank and in hand

p) Creditors and provisions

1 Accounting policies (continued)

q) Financial instruments

r) Pensions

2 Income from donations and legacies

Notes to the financial statements

3 Income from charitable activities

Notes to the financial statements

6a Analysis of expenditure (current year)

Notes to the financial statements

9 Staff numbers

10 Related party transactions

11 Taxation

Notes to the financial statements

12 Tangible and intangible fixed assets

13 Property

13a Tangible fixed assets: Leasehold property (Ground floor only)

Notes to the financial statements

14 Investments

Subsidiary undertaking

15 Debtors